A nurse receives a report on a client with a basilar skull fracture. What findings should the nurse expect with this client?

Choice A rationale
Serotonin is indeed an inhibitory neurotransmitter. It helps regulate mood, appetite, and sleep among other things. However, its role in the nervous system is complex and it can also have excitatory effects depending on the specific receptors and neural pathways involved.
Choice B rationale
Gamma-aminobutyric acid (GABA) is the primary inhibitory neurotransmitter in the brain. It works by decreasing neuronal excitability, which helps to regulate muscle tone, among other functions.
Choice C rationale
Acetylcholine is primarily an excitatory neurotransmitter, although it can have inhibitory effects in certain parts of the nervous system. It plays a key role in muscle activation, learning, and memory.
Choice D rationale
Dopamine can act as both an inhibitory and an excitatory neurotransmitter, depending on the type of receptor it binds to and the specific neural pathway involved. It plays key roles in reward, motivation, and motor control.

Choice A rationale
Penetrating traumatic brain injuries can cause significant damage to the brain. The extent of this damage is often related to the size, route, and speed of the object entering the brain. A larger, faster object or one that follows a path through vital areas of the brain can cause more severe injury. This is because the object can disrupt normal brain tissue and function, leading to a range of potential effects, from temporary changes in brain function to long-term complications or even death.
Choice B rationale
While it is true that a penetrating injury can cause leakage of cerebrospinal fluid (CSF), this is not the primary source of damage in such injuries. CSF leakage can lead to complications such as meningitis, an infection of the protective membranes covering the brain and spinal cord.
However, the primary damage in penetrating brain injuries comes from the direct physical disruption of brain tissue by the object.
Choice C rationale
Coup and contrecoup injuries are terms used to describe injuries that occur at the site of impact (coup) and on the opposite side of the brain (contrecoup). These injuries are typically associated with blunt force trauma, not penetrating injuries. In a penetrating injury, the damage is localized to the path that the object has taken through the brain, rather than at the point of impact and its opposite side.

Choice D rationale
While a penetrating object can indeed shatter the skull and potentially cause an infection, the primary damage in penetrating brain injuries is caused by the direct injury to the brain tissue itself. Infections are a secondary complication that can occur if bacteria enter the brain through the wound.